My husband, Marv, took his last breath around four yesterday morning, Wednesday, July 25, 2018. Even though heavily medicated he seemed to know that he had to get up at his usual time and go somewhere. Spooned behind him on our king-sized bed, my left arm tucked around his side, I suddenly felt the absence of his chest rising with breath. In the soft dim lighting that shone over him, I opened my eyes and started counting: one, two, three…up to eleven. On the count of twelve, he took in a deep breath for the last time and exhaled quickly into the quietness of death.
I bounded out of bed, down the hallway, to our guest room where our daughter was sleeping. As I cracked open the door, I saw her bolt to the edge of the bed. “He’s gone, isn’t he,” she said.
Minutes later, the CD player at his bedside clicked into his favorite song, “I come to the garden alone…”
Mid-afternoon the day before, Tuesday, I’d told Kathleen to go home for the night. She’d been here with me for several days and nights, and I said, “With Dad’s orneriness, he’s likely to hang on a few more days and one of us has to get some sleep.” Later in the afternoon, I texted her, “If Dad dies during the night, do you want to be here when hospice comes?” Minutes later she answered, “I can come and stay if you would like that.” I said, “Sounds good. Especially since I could not turn Dad without him crying in pain. Leaving him on his left side for now.”
Marv’s final turn in his condition started just a month ago, about six months after diagnosis. Six months of nearly normal living. Six months that we gave thanks for every day of this last month.
His worst pain emanated from his abdomen which began to grow noticeably from day to day. On Monday, three days ago, the hospice doctor ordered a CT scan. Marv and I just had to know exactly what we were dealing with. Bowel obstruction? Fluid retention? Tumor?
Our daughter brought us to the hospital at four. For Marv, who has always walked ten steps ahead of me, shuffling slowly at my side, cradling his painfully distended abdomen with his arms, the trip to the lab for a blood draw, then to the cubicle for the start of an IV, then to another room to drink the two bottles of prep, then to another room to get on the table for the scan and then down again, was summed up to me as I retrieved him from the CT tech, “I could hardly do it,” he whispered, “Do what?” I asked. “Get my legs, my body, up on the table.”
I texted our daughter, who’d been waiting with our grandkids in a nearby parking lot, that we were waiting out front. Marv stood, arched over a waist-high trash receptacle, silently moaning in pain. I had to lift his legs to get into the SUV. My husband, who has always run circles around us, now could not lift his legs.
The kids had been to camp and Grandpa asked, first thing, “How was your day? What did you do?’ He’d just wished all the technicians we’d encountered a good day, so I was not surprised that his first words to the kids were to ask about their day.
At home, I had to help Marv get his legs turned and out of the SUV. He staggered over to his lawn chair out front. “Ask Kath to make me some coffee, will you?” He knew his daughter would put in the three heaping teaspoons of bold instant Folgers that he liked. A package had arrived. I opened it—from my one remaining sibling (from four), my sister from Seattle and her four daughters. Kathleen took our picture.
I hoped we wouldn’t have to wait until Tuesday to hear the results, but I needn’t have feared. The hospice doctor called within an hour of our being home. Marv’s abdomen was full of cancer. No bowel obstruction. No fluid retention. But tumors, lots of tumors.
I was sitting at our kitchen table, scribbling notes as he talked. He detailed the results of the scan and then detailed a medication regimen to provide for no more pain. He said I had the option to bring Marv into their hospice house, but he’d heard from the nurses that we were determined to stay at home. He asked, “Are you up for this?” When I said yes, he said, “Are you sure?” Of course, I was going to do this at home. We had made that decision early on: he would die at home.
Then I brought the phone outside to Marv. “Hi,” he boomed to the doctor as if he was greeting an old long-lost friend. He motioned to me to put the phone on speaker. After the doctor explained to him at length about what they’d found, Marv said, “You know on the farm when cattle got bloated, we just stuck a pipe in their sides to let the air out, and they would be so relieved, they’d smile at us afterwards. If you’d just stick a pipe into my belly right now, I’d smile for you too.”
Marv was grinning as we heard the doctor chuckling. They joshed around for at least another twenty minutes. Then it was time for more morphine.
That night, Monday, we said our bedtime prayer together for the last time. He always prayed, but as we lay on the bed, he didn’t start up, so I said, “I’ll pray tonight, honey.” After a few sentences, I asked him if he’d like to add anything. It was quiet for several long seconds. Then, with labored breath and husky voice, he prayed, “Help us to just finish out, without, pain … discomfort … to transition …” And those were his last words. It was around ten Monday evening.
From that time until four in the morning yesterday, Wednesday, I medicated him every four to five hours with the lowest doses of medication prescribed by the hospice doctor. As I dripped the medication by syringe into the deep corners of his mouth, my eyes would tear and I would think, “I never, ever, thought I’d use my nursing skills to help my husband die.” Then I would remind myself, “It’s the last thing I can do for him. To help him fulfill his wish to die at home. And to help him, as we’d always learned in nursing, to die with dignity.”
And I must say a huge thank you to Avera@Home Hospice, especially Kim, our regular nurse, Celeste, our social worker, and Kristi, our chaplain. Marv looked forward to their visits, except for the chaplain. When she’d called the first time, he’d told her with a smile in his voice, “I won’t need you, but my wife will.” They walked with us from the beginning, starting at weekly and ending up to more than once a day. Their phone numbers were first on my phone. The last week, they answered my calls in the wee hours of the night. Before dawn yesterday, Pam was here within twenty minutes of my last call. She had offered earlier in the night to come sit with me if I wanted. While we stood at the bedside for the final time, she conducted a liturgical prayer of thanks to God, she as leader and our daughter and me as readers.
A friend sent this prayer today, a favorite of Marv’s and mine at Fourth Presbyterian of Chicago:
Deep peace of the running wave to you.
Deep peace of the flowing air to you.
Deep peace of the quiet earth to you.
Deep peace of the shining stars to you.
Deep peace of the gentle night to you.
Moon and stars pour their healing light on you.
Deep peace of Christ,
of Christ the light of the world to you.
Deep peace of Christ to you.
God is good.Thank you for walking along with us on our “adventure,” as I called it from the beginning. An adventure into God’s abiding grace.